| NPI | 1124037122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: TX F5186) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MS 07297) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2009-05-14 |